New Patient Information

Chinese Medicine PaperworkNew Patient Paperwork

Please print, fill out, and bring your new patient paperwork with you to your first appointment, arriving 5 minutes early. This will allow your practitioner a chance to review the information prior to your appointment.

Alternately, you may arrive 35 minutes early for your appointment and fill out the paperwork in the clinic. We can also mail it to you.

→  Download new patient paperwork (opens as a PDF).

Patient Confidentiality

In compliance with healthcare patient privacy regulations, all patients age 18 and over must contact the clinic directly for scheduling and other healthcare related concerns. If you would like to designate someone to speak with the clinic on your behalf, contact us for a “Consent to Practitioner Discussion” release form.

We require all patients (ages 18 and over and as able) to personally confirm their appointments with the clinic.

Insurance Verification

We accept Blue Cross Blue Shield and Cigna health insurance. If you would like to use insurance and are unsure whether or not your plan covers acupuncture, please contact us for verification at least 72 hours prior to your appointment.

→  Submit an online insurance verification form.

Directions to The Clinic

Jade Mountain Wellness is located on Kilburn Street, just south of Downtown Burlington, approximately half way between Pine Street and Saint Paul Street. We are in the historic Kilburn & Gates Building.

The Kilburn & Gates Building is large building with several entrances. The easiest way to find our office is to locate yourself on Kilburn Street directly across from the single story brick building with the large Evolution Yoga sign. You will find our entrance clearly marked.

Free parking is available on the street as well as in the two lots across the street from the entrance to the office.

→  View clinic directions in Google Maps.


Accessible parking spots are located on our side of Kilburn Street, closer to the intersection of Saint Paul Street. The clinic is in the first story of the building, and the entrance is ADA compliant.

Clinic Hours

Monday, Tuesday, and Thursday: 9:00am – 7:00pm.

Friday, from 10:00am to 5:00pm.

The clinic is closed on Wednesday, Saturday, and Sunday.

Appointment Costs

All patients must first schedule a new patient appointment, where the practitioner will review your health history, preform Chinese medical diagnostic work (including pulse diagnosis and tongue diagnosis), and a full treatment (depending on appointment type). For a full review of policies, fees, and payments, click here.


1st visit is $135, follow up appointments are $90. Both appointments include a full acupuncture appointment and herbal prescription writing (as needed).

Herbal Medicine

1st visit is $100, follow up appointments are $50. Herbal medicine appointments do not include an acupuncture treatment nor the costs of herbs themselves. The appointment consists of diagnosis work and writing your individualized/custom herbal prescription.

Rescheduling and Cancellations

We schedule each appointment time for one patient. A minimum of 48 hours advance notice is required for rescheduling and cancellations.

If there is a personal emergency, sickness or inclement weather, cancellation with less notice is fine.

If less than 48 hours notice is given, full payment is expected for the missed appointment.

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